This study had the following goals: ( 1) synthesize data on LME proportions in neurological diseases, including potentially distinct LME features such as phenotype or temporal evolution ( 2) qualitatively and quantitatively summarize the potential association of LME with clinical and imaging features in MS ( 3) propose an appropriate imaging protocol to detect LME in clinical and research practice ( 4) summarize the data on pathological correlates of LME in neuroinflammation ( 5) summarize the available evidence on LME in animal models of neuroinflammation. With respect to MS, several studies have presented conflicting findings regarding the association of LME with clinical and imaging parameters,( 5) such that high-level evidence would benefit clinicians and researchers.īased on these shortcomings, we set out to systematically summarize the available evidence on LME in neurological diseases with a focus on MS. Furthermore, a wide variety of methodological approaches to imaging LME has been published,( 3, 4) impeding the implementation of an appropriate imaging protocol for sensitive LME detection. However, there is a lack of systematic evidence on LME proportions in MS and other neurological diseases. LME in MS was associated with longer disease duration (mean difference 2.2 years, p=0.03), higher Expanded Disability Status Scale (mean difference 0.6 points, p=0.006), higher T1 (mean difference 1.6ml, p=0.04) and T2 lesion load (mean difference 5.9ml, p<0.001), and lower cortical volume (mean difference −21.3ml, p=0.002).īecause LME can be present in a wide variety of neurological diseases,( 2) differential diagnostic considerations are paramount for proper patient workup.

In a subgroup analysis comprising 1605 MS cases, LME proportion was 0.30 with lower proportions in relapsing-remitting (0.19 ) compared to progressive MS (0.39, p=0.002) and higher proportions in studies imaging at 7T (0.79 ) compared to lower field strengths (0.21, p<0.001).

The LME-proportions for these disease classes were 0.47, 0.59, and 0.26, respectively. Results Of eligible publications, 161 investigated LME in neoplastic neurological (n=2392), 91 in neuroinfectious (n=1890), and 75 in primary neuroinflammatory diseases (n=4038).

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